SDS_response_to_pt_survey_2013
Transcription
SDS_response_to_pt_survey_2013
Patient Participation Introduction and Objectives Station Drive has enjoyed an active Patient Participation Group. The role patients play in helping to determine care and how it is delivered should not be underestimated. The Station Drive Patients Participation Group has been particularly active and is represented on the Locality Board and the main CCG Board. Members also sit on Mental Health and other committees and have had an active voice in the debate around the proposed Ludlow Health Facility. The key objective of the DoH has been to ensure that patients are as involved as practical in decisions about the range and quality of services provided. The Station Drive Patients Group have been involved in survey and direct questioning of the patients of the surgery using flu days and other opportunities to promote dialogue and debate. This year (2013/4) The group has had active meetings with the Dementia lead for the CCG, engaged in a Care Coordination project and also recruited patients to Compassionate Communities. As the Chairs reports and meeting minutes also reflect the group continues to actively ensure that views of the population of South Shropshire are heard at a range of Patient Participation CCG and Ludlow Healthcare planning events. Components of Patient Participation Develop a PRG The Patient Group has been running for 3 years and was constituted by open invitation to all patients. A large notice board is available in the Waiting Room regularly updated by the group along with a suggestions box. The aim has always been to encourage participation from the widest demographic possible and the practice reception team encourage new patients to become involved and also suggest attendance at meetings to all who wish to influence the way the surgery is run. To highlight the group Patient Participation Group representatives attend the flu day (where over 1000 of our 8300 patients attend) this provides an opportunity for survey of the patient group and discussion of any hot topics. Carers are especially encouraged as this sub population has direct and often very pertinent knowledge of the needs of the vulnerable and direct comment on how health care is developed. The group in its January meeting encouraged a wide audience by promoting a discussion led by the CCG lead for dementia. The Practice encourages engagement through: Proactive invitation to all new patients to join the group Web page and dedicated web space for all minutes and notices Notice Board and Suggestions Box Direct engagement and representation at all meetings with the presence of at least one doctor and often other staff members (such as the Care Coordinator) The Station Drive Surgery Patient’s Group comprises 18 – 20 patients including an elected Chair and Secretary. The group interface with up to 1000 members of the practice population at the flu day (a weighted sample but because they comprise the elderly and those with chronic disease arguably a cross section of the main users of services) The PRG is based on this wider population for survey results and also a specific PRG Calculation has been performed on the survey sample from February 2014 The sample size for this survey was 344 Patients all of whom accessed the services in the week Male Female 70 60 50 40 30 20 10 0 under 15 15-20 21-40 40-60 60 or over The profile of this user sample is close to the profile of the PRG which comprises 15-20 members with a predominant elderly bias but fairly equal male female split. Racial minorities are represented in proportion to the underlying demographic. Components of Patient Participation Agree Areas of Priority The patient priorities are represented through discussion (as minutes) at the Patient Group, through on-going work on the Action Plan formulated in 2012/3 and also through survey at the flu day. At the 2013 Flu Day the Chair Secretary and Care Coordinator again attended (as in 2012) to gather ideas and feedback, encourage participation in the Patient Participation Group and also to evaluate response to the Action Plan and gather ideas and suggestions for any other issues to be included. The Action Plan is debated and considered at each Patient Group meeting (as Minutes) and again progress or otherwise made by the Practice is noted. At the Flu day in 2013 the key themes again were: 1. Opening times 2. Appointments availability 3. Telephoning the Practice 4. Manpower (locums and availability of doctors) 5. Ambulance and concerns over the Hospital (Planned redevelopment failing) 6. CCG Level decisions re priorities of care It was noted that the practice had started a telephone triage system such that all urgent demand was met by telephone response on the day, more on line appointments were offered, on line prescriptions available and that despite a national and deepening recruitment crisis and 2 years of trying to recruit with national advertisements the practice had secured more permanent workforce (Dr Moore and latterly Dr Wood) The question format therefore for the February Survey was chosen to reflect these themes. The practice also (as in 2011) requested that individual clinician level data could also be collected. Components of Patient Participation Collate Patient Views through use of a survey Face To Face Survey The Patient Group chose to conduct the survey by face to face discussion with patients visiting the Practice for a ‘flu vaccination at the Saturday morning special clinic on 28th September 2013. Replicating the Survey of 2012 Three members of the group again spent 4.5 hours each talking to patients and recording their issues. The PRG reported back to the Patient Group and as in the previous year a full range of comments and discussion was considered. This was presented at an open meeting and it was determined that the PRG would both update the Action Plan and also the Practice chose to repeat the 2011 Survey to see what progress (or other) had been made around the key areas of the action Plan. Survey credibility Whilst the survey did not address a randomized group of patients the very large numbers and the direct and open discussions facilitated by the PRG were felt to provide a very credible and representative formative output and survey. Direct Survey As in 2011 and using exactly the same methodology a wide scale Patient Survey was undertaken during the week commencing 24th February 2014 The Direct Survey was designed to follow up on 2011 and look for change in terms of the Action Plan Agreements and proposals. The direct survey as in 2011 also used GPAQ (General Practice Assessment Questionnaire) questions to allow clinician feedback. A simple GP Tools form was used to allow this. Components of Patient Participation Opportunity to Discuss Survey Findings/Agree actions The feedback from the Flu day survey was discussed at the Thursday 3rd October 2013 meeting as minutes (on website) No new issues other than the relative low awareness of the Practice Website were recorded. Patient Group Members also asked that clearer information about opening times is posted (again the knowledge around existing extended hours and the early morning phlebotomy service for fasting bloods was not well publicised. Complaints and significant events are discussed within the practice and the group routinely reviews comments or suggestions received. Full and detailed minutes of the group are maintained and are posted on the Patient Group section of the practice website. The flu day survey provided an opportunity to review progress against the action plan and a new theme re awareness of online booking website and opening times was added. The survey in February 2014 was designed to monitor progress (using the standard questions set in 2011. The findings of the 2014 Survey are appended In short the following were noted An increase even in a year of the frequency of consultation No change in the rating for reception No change in the need for privacy at reception (still seen as a need by nearly 20%) No statistical change in rating for availability but perhaps a shift toward more satisfaction No change in awareness of early morning and late evening working (we were surprised that 30% were still unaware) An improvement in access with 74% seen immediately or on the same day A slight improvement in waiting time for doctors and nurses A large improvement in telephone access63% saying easy compared to 50 in 2011 An ongoing demand for on line text and other messaging services and prescription requests. The actions are reviewed quarterly at meetings of the Patient Group. There is a dynamic and ongoing discussion as recorded in the minutes of actions arising and progress or lack of. Components of Patient Participation Opportunity to Discuss Survey Findings Telephone system – problem of getting through especially in the mornings Progress Feb 14 Telephones – difficulty in using the new system Progress Feb 14 Access to named Doctor and problem of turnover of GPs Progress Feb 14 ACTION WHEN BY WHOM To audit call back wait times March/May Reception To trial dedicated telephone answering responsibilities for Receptionists Immediate Reception To consider message (esp in light March of 111) To look at reducing telephone May Reception and Clinical demand by adjustment to results Team protocols Call Back times were audited and a re-audit is due Clinicians continue to adjust results reporting to provide more patient information and are actively considering on line access to pathology and other results. More patient friendly descriptors of results (eg cholesterol x no action required other than low cholesterol diet) have been introduced. Continues to be an “active issue” re audit Feb 14 survey Reception team to review message May Reception and to arrange meeting with Patient Group Patient Group representation to modify/amend message. Message was reviewed and options streamlined Recruitment of new GP Partner Advertising Partners February Ongoing advertising has occurred with both national (BMJ /Pulse) and local advertisements. The practice also contracted a head hunter to look for suitable applicants. Dr Sally Wood has been recruited and Dr Wieland Moore continues working at the practice. Locums wherever possible are chosen from a restricted pool. It was noted that despite best efforts recruitment remains a huge issue for the practice (and many others in the Marches) The current GPs are all working very long working weeks to provide continuity of care. This issue has been flagged with the CCG and LAT and has registered on the National agenda with efforts to increase GP training. The practice has confirmed status as a Training Practice and has welcomed Dr Ade Buluro and latterly Dr Samara Afzal. These fully qualified training GPs continue to help providing additional resource Confidentiality at the Reception desk Progress Feb 14 Ventilation in waiting room Progress Feb 14 Advertise volunteer car service Progress Feb 14 Magazines in waiting room Progress Feb 14 online appointment booking for Nurse appointments Progress Feb 14 prescriptions Progress Feb 14 test results system Progress Feb 14 To remind all Receptionists of this February Practice Administrator issue, and to close the hatch when not dealing with a patient Has been completed. With the news that the new Ludlow Healthcare facility is not being built we need to consider the mechanics of the practice. A confidential area for BP Height and weight measures and display of patient leaflets which require more confidentiality (youth sex health/ contraception/HIV etc is being arranged. Re audit Make one duty Receptionist February Receptionists responsible for checking 2013 temperature of waiting room and taking action. Done Practice to ask Care Co-ordinator May Patient Care coto liaise with Patient Group ordinator Care Coordinator has changed this discussion now rests with Co Co (Compassionate Communities and has been forwarded) New Care Coordinator should be in post by March but longer term post in FY 14/5 not assured yet) Patient group to review and April Patient Group discuss how this can be improved. Done Old mags removed Implement this May Reception team Nurse appointments are variable length depending on procedure we will implement this in due course but resolution of appt length etc required and Patient Info to be available Discuss frequency of prescriptions June/July Partners, with CCG and then strategic review CCG confirm normally prescriptions should be 1 month, locally for certain long term drugs eg statin or blood pressure we extend this. Strategic review planned with CCG Pharmacist but not yet tsarted. Process review of this system March Partners, and Practice admin team rep. In progress especially as on line anticipated. Components of Patient Participation Action Plan agreed ongoing Telephone system Access to named Doctor and problem of turnover of GPs Confidentiality at the Reception desk online appointment booking for Nurse appointments test results system New Actions 2014 Publicise website/on line services Advertise extended hours ACTION To audit call back wait times To look at reducing telephone demand by adjustment to results protocols Recruitment of new GP The practice needs to continue to monitor workforce and proactively secure more doctors as needed To remind all Receptionists of this issue, and to close the hatch when not dealing with a patient Consider remodelling Implement this WHEN Ongoing audit BY WHOM Reception and Clinical Team Ongoing Partners Sept 2014 Practice Administrator May 14 Reception team Implement On line access June 14 Partners, Admin Team ON line access to prescriptions now printed on all prescription counterfoils Continue to promote extended hours extended phlebotomy etc and advise patients of changes regularly revise website Feb 14 onward Ongoing Admin team